Investments in respiratory infectious disease research 1997-2010: a systematic analysis of UK funding

Objectives Respiratory infections are responsible for a large global burden of disease. We assessed the public and philanthropic investments awarded to UK institutions for respiratory infectious disease research to identify areas of underinvestment. We aimed to identify projects and categorise them by pathogen, disease and position along the research and development value chain. Setting The UK. Participants Institutions that host and carry out infectious disease research. Primary and secondary outcome measures The total amount spent and number of studies with a focus on several different respiratory pathogens or diseases, and to correlate these against the global burden of disease; also the total amount spent and number of studies relating to the type of science, the predominant funder in each category and the mean and median award size. Results We identified 6165 infectious disease studies with a total investment of 2 pound center dot 6 billion. Respiratory research received 419 pound million (16.1%) across 1192 (19.3%) studies. The Wellcome Trust provided greatest investment (135.2 pound million; 32.3%). Tuberculosis received 155 pound million (37.1%), influenza 80 pound million (19.1%) and pneumonia 27.8 pound million (6.6%). Despite high burden, there was relatively little investment in vaccine-preventable diseases including diphtheria (0.1 pound million, 0.03%), measles (5.0 pound million, 1.2%) and drug-resistant tuberculosis. There were 802 preclinical studies (67.3%) receiving 273 pound million (65.2%), while implementation research received 81 pound million (19.3%) across 274 studies (23%). There were comparatively few phase I-IV trials or product development studies. Global health research received 68.3 pound million (16.3%). Relative investment was strongly correlated with 2010 disease burden. Conclusions The UK predominantly funds preclinical science. Tuberculosis is the most studied respiratory disease. The high global burden of pneumonia-related disease warrants greater investment than it has historically received. Other priority areas include antimicrobial resistance (particularly within tuberculosis), economics and proactive investments for emerging infectious threats.